EchoPixel’s technology plays critical role in success of conjoined twins surgery

“There is a better way” is a common mantra heard frequently in discussions between Fogarty Institute mentors and its entrepreneurs. It’s what drives us each day to devise and create new technologies that will transform patient care. And while the process is not always easy, there is nothing more rewarding than seeing a successful patient outcome as a result of a device that was created right here, in our own “family.”

That’s why we felt great pride the day that one of our companies-in-residence played a critical role in a complex surgery that redefined the lives of two toddlers and their family.

In early December 2016, two-year-old conjoined twin sisters Eva and Erika Sandoval were successfully separated during a 17-hour surgery that took place at Lucile Packard Children’s Hospital Stanford.

It took a team of 50 people, which included some of the best physicians in the world, to perform this very complex surgery, since the twins shared numerous organs. Led by Gary Hartman, MD, a clinical professor of surgery at the School of Medicine, it marked the fifth separation he conducted at Stanford, but the first time his team used a true 3D interactive virtual reality imaging system to help plan the surgery and address unexpected complications.

By using 3D glasses and a special display, the software, developed by Fogarty Institute startup EchoPixel, allows physicians to view and interact with organs as if they were physical objects, offering an unprecedented way to examine patients’ anatomy from every angle.

Frandics Chan, MD, Stanford cardiac radiologist and associate professor of radiology at the Stanford University Medical Center, worked with EchoPixel to develop the virtual reality tool and has used it to help physicians better visualize complex congenital heart cases in both adults and children.

He also used EchoPixel’s technology to help the conjoined twin’s surgical team prior to and during the surgery. Most notably, he used the VR tool to assist the surgeons visualize the complex pelvic anatomy of the conjoined twins, who between them shared three legs, one of which was not functional. The imaging played a critical role in allowing them to plan the best way to separate the sisters without major vessels bleeding out.

During the surgery, Dr. Chan was called in four times to answer questions on how to best approach unexpected complications, all of which were addressed with the help of the VR system. Specifically, EchoPixel’s technology helped confirm the orientation of the twins and the location of blood vessels going through the liver; determined which girl owned the single colon; and provided solutions for how to use the leg that wasn’t functional.

“EchoPixel’s technology was indispensable during the planning process and the surgery itself,” said Dr. Chan. “In complex cases, which are ripe for complications, the software allows physicians to familiarize with the abnormal anatomy just before they open the body. This can give them insight into the best way to proceed during the surgery, minimizing unexpected situations.”

The twins slept in separate beds for the first time following the surgery and one of them has already been discharged. There could not have been a more storybook ending for these two young girls.

For EchoPixel, it’s one more rewarding success story for the startup. In addition to situations like the conjoined twins, the technology has promising applications to solve a broad range of complex cases, including diagnosing and treating complicated cardiac conditions.

“Our True 3D Viewer has demonstrated significant results in a range of applications, from device sizing to virtual colonoscopy, but we’re particularly excited about our progress in pediatric cardiology,” said Ron Schilling, CEO of EchoPixel. “We’re honored to play a role in the success of these difficult operations, and to assist physicians in understanding and working with patient anatomy.”

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